Various neurological conditions and disorders are known, which can affect various neurological related functions of subjects afflicted with such conditions. The neurological conditions impair one or more functions or parts of the neurological system, which may results in impaired functioning of a subject afflicted with such condition. For example, symptoms of neurological conditions may include cognitive, emotional, sensory and motor impairments.
Many neurological conditions are known in the art. For example, stroke or cerebrovascular accident (CVA), is a condition which commonly occurs in elderly individuals (over 65) and may be divided into two categories; ischemic CVA and hemorrhagic CVA. Ischemic CVA is caused by blockage of a blood vessel supplying blood to the brain resulting in temporary or permanent damage to the neurons in that area. The blockage of the artery can be a result of an embolus, occlusion of the artery due to a local formation of a blood clot, narrowing of the artery due to deposits (such as, for example, calcium, cholesterol, lipids and the like) in the intima and media layers of the artery walls. If the symptoms subside completely within 24 hours, the CVA is considered a transient ischemic attack (TIA). Hemorrhagic CVA- is caused by tear of the artery walls which causes bleeding into the brain resulting in both a compromised blood supply to the area of the brain supplied by the blood vessel (hence resulting in localized damage) and an increase in the intracranial pressure (hence resulting in damage to the entire brain). Any process that weakens the artery walls will increase the risk for a hemorrhagic stroke. Such processes include, for example, an aneurism, amyloid angiopathy and others.
Another neurological condition is Traumatic Brain Injury (TBI). TBI is an injury to the brain as a result of a force applied to the head which exceeds the ability of the natural protective mechanism to protect the brain. This may cause a penetrating head injury or blunt head trauma which may injure the brain. In both cases the blood supply to the brain may be compromised. Bleeding can result in an epidural hematoma, subdural hematoma, subarachnoid hematoma or bleeding within the ventricles of the brain. The type and severity of the symptoms of CVA and TBI may vary greatly ranging from death or a deep comatose state to lack of any long term symptoms. Patients who are in need of a treatment may suffer from any or a combination of the following symptoms: hemiparesis, monoparesis, increased/decreased muscle tone, reduced balancing abilities, dysmetria, loss of parts of the field of vision such as hemianopsia, aphasia (motoric or sensory), dysarthria, central pain, diminished cognitive capabilities as well as other problems.
An additional neurological condition is Anoxic Brain Damage (ABD). Anoxic brain damage is caused by lack of oxygen supply to the entire body affecting the brain. Causes can include drowning, asphyxiation, myocardial infarction leading to asystole (heart attack) or a severe arrhythmia of the heart such as ventricular fibrillation. Symptoms may affect all brain functions and include cognitive, emotional, sensory and motor impairments.
Another neurological condition is Cerebral Palsy (CP). CP usually occurs due to compromised blood supply to motor or motor related areas of the developing brain. The damage may occur during pregnancy, congenitally or up to the age of 3 years. The term Cerebral Palsy is directed to many subtypes of movement disorders, the most common of which is spastic CP. The symptoms may include the lower limbs such as in spastic diplegia, or the symptoms may involve the upper limbs as well such as in hemiplegia or hemiparesis, mixed hemiparesis (when for example one hand and the contra lateral leg are involved), quadriplegia/quadriparesis. In a minority of the cases some patients may suffer from athetoid CP or ataxic CP. The condition itself is non-progressive but since movement disorder is present from the beginning of life it may have a severe impact on the growing musculoskeletal system. CP patients may have asymmetric hands or legs (left compared to right), scoliosis, early onset of osteoarthritis and other musculoskeletal ramifications. Aside from the musculoskeletal direct and indirect effects CP patients may also suffer from disturbances of sensation, depth perception and other sight-based perceptual problems.
An additional neurological condition is Parkinson's disease (PD). Parkinson's disease is a progressive disease involving the basal ganglia network, mainly the sustantia nigra. The progressive lack of the neurotransmitter dopamine slowly affects all the functions of the basal ganglia network which include movement control, balance, cognitive functions, affect, perception (visual and cognitive) and others. The direct symptoms of the disease include tremor, rigidity (increased muscle tone) bradykinisia (slowness of movement), shuffle gait, festinating gait, freezing episodes, impaired balance and a forward flexed posture. Muscle and joint pain are common results of the above direct symptoms of the disease. As the disease progresses patients show mental decline and may develop hallucinations.
Another neurological condition is Multiple Sclerosis (MS). Multiple sclerosis (MS) is an inflammatory (autoimmune) progressive disease of the central nervous system (spinal cord and the brain). The inflammation process leads to break down of the myelin sheaths of the axons, rendering them unable to conduct neural impulses. Several subtypes have been described according to the progression of the disease: Relapsing remitting, Secondary progressive, Primary progressive and Progressive relapsing. The disease may impact all or any of the areas of the central nervous system. Symptoms may include sensory symptoms (loss of vision, proprioceptive deficits, loss of superficial sensation from various areas etc.), motor symptoms (paresis or paralysis, high muscle tone, clonus etc.), ataxia, cognitive symptoms, fatigue and pain. As the disease progresses, most patients condition becomes worse and they need support during ambulation. Supports can include braces, ankle-foot orthoses, sticks and walkers. In most cases independent ambulation becomes impossible after a while.
An additional neurological condition is Spinal Cord Injury (SCI). SCI may be cause by blunt force such as a fall off height, penetrating wounds such as gunshot wounds or surgical interventions, disc pathologies and fractures of the spinal column. SCI can cause complete destruction of the cord or any degree of partial damage to it. The degree of damage to the cord as it is expressed in the ability of the muscles to function is the basis for the most widely used classification for SCI: the American Spinal Injury Association scale, commonly known as the ASIA scale (for example, see http://www.sci-info-pages.com/levels.html). In the vast majority of the cases, the injury causes damage to both sensory and motor nerves in the spinal cord, resulting in both sensory and motor deficits. These deficits can be seen below the level of injury or at the level of injury. Patients who have suffered an injury to the cervical spine are likely to have symptoms which include the upper and lower extremities, a condition called quadriplegia or quadriparesis. Patients who have suffered an injury to the thoracic spine or lower will have symptoms which include the lower extremities, a condition called paraplegia or paraparesis. Some of the SCI patients develop central pain in the hypoaesthetic/anaesthetic areas of the body. This type of pain is caused by the injury to the neural circuitry in the CNS. Patients with an injury rated A or B on the ASIA scale are unable to walk. Most of the patients who score C to E on the ASIA scale are able to walk but may need assistance in the form of braces, artificial foot orthoses, sticks or walkers. All SCI patients have a high probability of developing pressure sores, deformities due to increased muscle tone and muscle contractures, osteoarthritis and joint damages due to gait deviations as well as a multitude of visceral and vascular problems. All of these are secondary to the SCI.
Another neurological condition is Charcot-Marry-Tooth (CMT). CMT is a genetic defect in the axons and myelin sheaths of the peripheral nerves. In most cases the longer nerves are most affected and most patients have more severe symptoms in their feet and hands. Motor and sensory (touch) nerves are affected. The first symptom to appear is often drop foot. The symptoms usually appear in the late teen years and in the vast majority of cases progress slowly or even stop progressing within a few years. Due to the wasting of the muscles the joints of the feet often become deformed and weight bearing becomes painful. In order to support the deformed structures and the weakened muscles braces and insoles are widely used.
An additional neurological condition is Guillain-Barré syndrome (GBS). GBS is neurological disease which is caused by an autoimmune reaction to a virus. The autoimmune reaction attacks the peripheral nervous system which leads, in most types of the disease, to a progressive loss of neural functions advancing from distal to proximal. The immune system attacks the myelin sheaths which surround the nerves and enable proper conduction of neural signals along the axon. Some cases develop a paralysis of the respiratory muscles which may render the disease potentially fatal. Such cases require mechanical ventilation. Known treatment includes plasmapharesis or the administration of intravenous immunoglubulins. These treatments must be given within the first two weeks following the initial symptoms and are both aimed at reducing the autoimmune reaction in order to minimize nerve damage. The course of the disease is usually self-limiting and most (about 80%) patients recover completely within a year. Some cases continue to exhibit signs of neural damage.
An additional neurological condition is Poliomyelitis. Poliomyelitis is a viral disease which in the vast majority of cases affects the digestive system and the blood (viremia). In a small percentage of cases the virus attacks the motor neurons in the spinal cord, brainstem and motor cortex. Since the discovery of the vaccine in the 1950's, polio epidemics are virtually nonexistent in the western world. In third world countries some new cases may appear, most commonly afflicting young children. Some of the patients which exhibit signs of paralysis recover completely while others continue to have varying degrees of paresis or paralysis. Since the disease is usually contracted at a young age the prolonged paresis or paralysis leads to severe disfigurement of the affected limbs. The paralytic limbs become smaller in comparison to the healthy limb and in many cases also rotated abnormally. The weakened muscular support for the joints leads to uneven loads and unnatural forces acting on the joints and therefore joint degeneration. Many of the patients require the use of braces and artificial supports in an attempt to minimize the effects on the joints. Many of the patients can develop post-polio syndrome. The symptoms include new muscle weakness and extreme fatigue. Since over activity of the motor neurons has been found to be a contributing factor to the development of post-polio syndrome, polio patients are encouraged not to be overly active.
There is a need in the art for devices and methods that can treat such neurological conditions, improve neurological and muscular control and/or improve/reduce the outcomes thereof, in particular, outcomes related to the sensory system, the motor system and/or the movement of subjects afflicted with such conditions.